目的 探索新型冠状病毒肺炎(COVID-19)疫情期间,药学人员的主要工作内容与服务模式,以期为疫情防控提供参考.方法 通过总结我院药剂科在新型冠状病毒肺炎疫情期间药学服务情况,包括构建药事应急工作质量管理体系、制定COVID-19临时药品目录、启动发热门诊药房、开展临床药学服务等.结果 为150余例COVID-19患者和约400名医务人员提供了药学服务.在此期间除确保药品供应,还通过关注临床用药,降低患者用药风险.此外,中药预防大大降低了医务人员及非新型冠状病毒肺炎患者的感染风险,提高了患者的治愈率.结论 突发重大传染病事件过程中,药学服务工作涉及面广,药事管理专业性强.药剂科必须主动作为,积极应对并及时调整工作策略,以便在提高医疗救治能力的过程中发挥重要作用.

目的 探讨空降兵伞训致踝关节骨折的临床治疗方法 .方法本次研究对象为86例,其中6例闭合复位石膏外固定,80例通过手术治疗,其中18例下胫腓分离采用固定钉固定.结果 86例踝关节骨折治疗后,门诊随访10～26个月,平均13.5个月,骨折均愈合,未出现骨折畸形愈合、创伤性关节炎、伤口感染、骨髓炎等情况.根据AOFAS评分评价术后功能:优72例,良8例,优良率93.0％;平均96.8分.结论 伞训致踝关节骨折需要早期手术治疗,骨折复位固定顺序为外踝-后踝-内踝-下胫腓韧带,重视外踝解剖复位和下胫腓联合的处理等是踝关节骨折手术治疗的关键.

Objective To study the protective effect of a new protection device for ankle joints of airborne troops and recommend an effective method for reducing ankle injury during landing among airborne troops.Methods One hundred airborne soldiers were equally divided into experiment group and control group.All the subjects jumped off a standard airborne training platform 1.5 m high in training uniforms and paratroopers' shoes while the experiment group additionally wore ankle-protecting devices.Using the telemetering electromyography and FlexiForce(R)'s Economical Load & Force (ELF) system,the stress and respone of ankle joints and the muscle around them were tested and analyzed to confirm the practicability and reliability of protective devices.Results The ankle joint protection devices significantly enhanced the average EMG amplitude of the tibialis anterior muscle and the peroneus longus and brevis muscles before and after touchdown(P＜0.05),but failed to have significant influence on the gastrocnemius(P＞0.05).The experimental group with ankle joint protection apparatus reduced the varus and valgus stress of the ankle joint by more than 50％,and there was statistically significant diference between the two groups(P＜0.05).Conclusion The ankle joint protection device can effectively improve the myoelectricity activity of ankle extensors and limit the range of the varus and valgus of ankle joints,so the new ankle-protecting device has a significant protective effect on ankle joints of airborne troops during landing.

踝关节是人体负重量最大的屈戌关节,作为一个承重关节,在平稳步态下,踝关节会承受1.25倍体重的力;在剧烈活动下,则会承受5.5倍体重的力[1]。空降兵伞降着陆时伴有5 m/s的下降速度,加上垂直向下的重力加速度,踝关节承受的负荷更大。着陆时由于风速过大、着陆场地凹凸不平和着陆姿势失误等危险因素容易导致三踝骨折(Cotton骨折)[2]。Cotton骨折是踝关节骨折中较为严重的关节内骨折,

“五级”主官是部队的领导核心,包括军、师、团、营、连五级单位的领导干部.为出色做好新形势下军事斗争准备,确保履行“能打仗、打胜仗”的军事斗争要求,空降兵部队每年进行两期(每期15 d)近千人的“五级”主官培训,学习习主席系列强军兴军重要讲话精神,交流治军带兵经验.为确保培训工作顺利进行,解放军457医院抽调医护人员参与了伴随医疗保健工作.

Objective To explore in vitro cytotoxic activities of DCIKs against hepatocarcinoma cells by co-culturing cytokine-induced killer cells (CIKs) with dendritic cells (DCs) derived from peripheral blood of patients with hepatocellular carcinoma (HCC).Methods Peripheral blood mononuclear cells (PBMCs) were isolated from 23 patients with HCC and cultured with cytokines to induce DCs and CIKs.DCIKs were induced by co-culturing CIKs with DCs.After 14 days of co-culture,the phenotypes of DCIKs and CIKs were analyzed by flow cytometry,and their in vitro cytotoxic activities against SMCC-7721 and HepG2 hepatocarcinoma cells were measured by MTT assay.Levels of IL-12,IL-4 and IFN-γ in the supernatants of cell culture were detected by enzyme-linked immunosorbent assay (ELISA).Results High expressions of CD3+CD8+ and CD3+CD56+ were observed on DCIKs.The percentages of effector cells,cytotoxic activity and cytokine secretion were all significantly increased with DCIKs as compared with those CIKs without DC co-culture (P＜0.05).Conclusion Co-culture of CIKs with DCs can enhance the differentiation of effector cells and the cytolytic activities of CIKs against hepatocarcinoma cells in vitro.Immunotherapy with DCIKs may be a promising strategy for the treatment of patients with HCC.

目的探讨空降兵跳伞过程中踝关节骨折的具体部位分布和导致受伤的具体原因,为预防踝关节骨折提供科学依据。方法对我院骨科2002-2012年收治的全部空降兵踝关节骨折152例病人进行调查,统计骨折部位和致伤原因,并采用配比对照进行回顾性病例对照研究。结果跳伞导致的踝关节骨折中,内踝单踝骨折最多,占41.45%;内外双踝骨折其次,占35.53%;外踝单踝骨折占17.76%;三踝骨折最少,占5.26%。着陆姿势失误、地面凹凸不平、风速过大和踝关节疲劳损伤为踝关节骨折的危险因素,OR值分别为4.11、3.76、3.29和6.00;佩戴踝关节保护器具为踝关节骨折的保护因素,OR值为0.14。结论内踝骨折为空降兵踝关节骨折最常见部位;踝关节骨折主要与着陆姿势失误、地面凹凸不平、风速过大、踝关节疲劳损伤和未佩戴踝关节保护器具等因素有关,故跳伞时应增加佩戴踝关节保护器具,增强踝关节稳定性,从而减少踝关节的损伤。同时天气、地形等客观因素不容忽视,并应尽量避免踝关节带伤跳伞。

医院绩效管理,是通过对医院管理总目标的建立、目标分解、业绩评价、绩效反馈的一种管理活动。本文阐述了加强医院绩效管理的意义、医院绩效考核指标原则、当前医院绩效管理存在的问题、国外医院绩效管理指标体系借鉴和医院绩效管理对策,对研究医院绩效管理有理论价值和实践价值。

<正>对于遭受意外创伤或突发疾病的患者来说,院前急救是关系到患者生命的重要措施。我国流行病学数据表明,创伤患者在院前急救的患者中占有重要比例,约为35%～40%,给患者身体、家人心理和医疗支出均造成巨大的负担。为了有效做好相关防范,提前充足准备,保证合理调配资源,我们收集了某医院2010-2011年收治的1357例院前急救创伤患者的病

<正>临床上常有病情、病程类似病毒性肝炎,但病原学检查均为阴性,其中以急性黄疸型居多。依据西安2000年9月中华医学会传染病与寄生虫病学分会、肝病学分会联合修订的《病毒性肝炎防治方案》[1],该类病例可诊断为:急性肝炎,病原未定。甲胎蛋白是一种胚胎性球蛋白,它在良性肝病中重现机制

Objective To explore the clinical efficacy of reduced glutathione in the treatment of druginduced liver injury of elder.Methods Seventy-two cases of diagnosed drug-induced liver injury were randomly divided into regular treatment group (n =34) and reduced glutathione treatment group (n =38).Both groups were given conventional liver protection therapy including energy mixture,diammonium glycyrrhizinate and potassium magnesium aspartate.Patients with the reduced glutathione treatment group were additionally treated with reduced glutathione 1.8 g,iv for 4 weeks.Results The total effective rate were 84.2％ for reduced glutathione treatment group and 61.8％ for regular treatment group.There was significant difference between two groups (x2 =4.6541,P ＜ 0.05).Conclusion Reduced glutathione can significantly improve drug-induced liver injury of the elder.

目的:探讨增生性外毛根鞘瘤(PTC)患者的临床、组织病理学特征及鉴别诊断.方法:对31例确诊PTC患者的临床和组织病理资料进行回顾性分析并复习相关文献.结果:31例 PTC 患者中,男16例,女15例,年龄12-89岁,平均54.45岁,病程2周～40年,平均75.88个月.皮损面部最多,19例,占61.29%.本组31例患者中,只有1例临床诊断PTC,准确率仅3.23%,误诊率96.77%.PTC组织病理特征包括真皮内多发性肿瘤结节,囊肿、非浸润性栅栏状边界、透明基膜带、外毛根鞘样骤然角化.结论:PTC临床容易误诊.诊断主要依靠组织病理特征,应与基底细胞癌、鳞状细胞癌、恶性 PTC 及外毛根鞘癌等鉴别.

近年来,尤其在实行全军医疗保障制度改革以来,院党委着眼新军事变革和卫生事业跨越式发展的新形势,以军事斗争准备为龙头,努力提高卫勤保障能力,坚持"姓军为兵"服务宗旨,牢固树立为兵服务思想;强化制度落实,确保医疗安全,坚持走质量建院,科技兴院,依法治院之路.医院的全面建设和为兵服务水平得到了明显提高.

A 20-year-old male patient presented with myalgia of upper limbs and myasthenia of extremities for more than 1 month. Physical examination showed diffuse erythema on the cheeks, upper eyelids, upper chest, neck and dorsa of the hands. The myodynamia of the proximal and distal muscles of upper and lower extremities was grade Ⅳ, Ⅴ, Ⅲ and Ⅴ respectively. Laboratory examinations revealed that the serum levels of creatine kinase, CK-MB and lactate dehydrogenase were 2103 U/L, 83 U/L and 489 U/L respectively, which were all above the normal range. Electromyogram revealed myopathic abnormality and normal nerve conduction velocity. Histopathology of gastrocnemius muscle showed hypertrophy and swelling of muscle fibers, disappearance or fuzziness of transverse striation, and intermuscular lymphoid cell infiltration. A biopsy of the skin lesion from the upper chest showed liquefaction degeneration of and colloid bodies in basal cell layer, perivascular lymphoid cell infiltration in the dermis. A diagnosis of dermatomyositis was established based on the clinical and laboratory findings. After management with intravenous prednisolone 80 mg once daily and symptomatic treatment for 4 weeks, the myodynamia of upper limbs was improved, serum levels of creatine kinase,CK-MB and lactate dehydrogenase reached the normal ranges. However, the myodynamia of lower limbs progressively deteriorated with the emergence of paresthesia. Enhanced MRI scan showed a tumor in the vertebral canal at the level of thoracic vertebra 11 to 12. A spherical encapsulated tumor measuring 3 cm in diameter was surgically removed. The tumor was diagnosed as paraganglioma in vertebral canal according to pathological and immunohistochemical findings. The patient was finally diagnosed with paraganglioma in vertebral canal superimposed on dermatomyositis.

<正>"5.12"汶川强烈地震发生后,顷刻间大面积房屋倒塌,道路中断,人员大量伤亡,灾区生态环境破坏,水源及食物污染严重,蚊、蝇、鼠、虫等大量滋生,易造成传染病的暴发及流行。空降医疗队采取了积极有效的卫生防疫措施,展开了持续广泛的卫生防疫工作,从而确保了救灾官兵的身体健康,确保了大

2008年5月13日,解放军第457医院受命抽组空降医疗队赴四川汶川地震灾区执行抗震救灾卫勤保障任务.现就此次抗震救灾卫勤保障谈几点思考:

目的 了解抗震救灾类强应激事件对空降兵抑郁状况的影响,为针对性做好心理防护提供依据.方法 应用抑郁自评量表(SDS)对参加四川抗震救灾67 d的空降兵某部320名士官和士兵进行测试.结果 空降兵SDS标准分为39.58±12.25,标准分≥50分者占23.13%,轻度抑郁占12.19%,中度抑郁占10.00%,重度抑郁占0.94%;有中重度抑郁症状的主要为士兵、新兵和跳伞次数<10次的人员(P<0.01).结论 服役时间长、跳伞次数多、级衔高的空降兵可不同程度地缓解由抗震救灾应激所产生的负性情绪,应重视新兵和士兵的心理状态变化情况.

新型农村合作医疗制度(以下简称"新农合"),这是一种以大病统筹为核心的农民互助共济医疗制度,是逐步实施全民医疗保障的重大战略举措,自2003年始,已在我国大部分地区试点并成功实施.作为国家卫生资源重要组成部分的军队医院系统,应在新型农村合作医疗制度的落实中发挥应有的作用,真正体现军队医院为民服务的宗旨.

为适应新时期军事斗争准备卫生救援的需要,空降医疗队应把平时卫勤保障融入战备卫生训练工作中,实现"拉得动、跳得下、展得开、救得好"的总目标.为此,应认真抓好"组织、制度、装备、伞降技术和医疗技术"的四落实,促进空降医疗队的全面建设与管理.